Bacteriological profile and antimicrobial resistance in sepsis cases in intensive care units in Lubumbashi: challenges and perspectives.

Abstract

Background: Sepsis remains a major public health challenge, leading to high mortality and morbidity rates, particularly among low-income populations such as those in sub-Saharan Africa. Its management is complicated by the emergence of multidrug-resistant bacterial strains, necessitating microbiological surveillance and adaptation of antibiotic therapy. This study examines the microbiological profile of sepsis and the antibiotic susceptibility of pathogens among critically ill patients in Lubumbashi, Democratic Republic of Congo.

Methods: A prospective study was conducted from January 2021 to December 2023 across three ICU units in Lubumbashi. Patients suspected of having sepsis were included, and microbiological samples were collected from various sources (blood, urine, pus, biological fluids). Bacterial identification and antibiotic susceptibility testing were performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using SPSS version 23^® and Excel 365^®.

Results: Among the 76 patients included, 40% had confirmed bacterial sepsis. The predominant isolates were Gram-negative bacilli (62.7%), with Escherichia coli (28.35%) and Klebsiella pneumoniae (22.73%) being the most common species. Gram-positive bacteria accounted for 33.89%, primarily coagulase-negative streptococci (15.11%) and Enterococcus faecium (5.61%). Antimicrobial resistance profiles revealed a high level of resistance to commonly used antibiotics, particularly cephalosporins, fluoroquinolones, and cotrimoxazole. However, greater sensitivity was observed with amikacin (41.3%), fosfomycin (37%), and meropenem (33.8%).

Conclusion: This study highlights the high prevalence of Gram-negative bacteria and concerning resistance to first-line antibiotics, jeopardizing the effectiveness of empirical treatments. These findings underscore the urgency of strengthening microbiological surveillance, rationalizing antibiotic use, and implementing antimicrobial resistance control policies in the DRC. Developing treatment protocols tailored to local data and enforcing stricter antibiotic regulations are essential to improving sepsis management and reducing associated mortality.